PREOPERATIVE MEDICATION USE AND POSTOPERATIVE DELIRIUM: A PREDICTORS OF POST-OPERATIVE DELIRIUM
| Main Author: | Nudrat Hussain, Rana Shoaib Akram, Anam Shezadi |
|---|---|
| Format: | Article |
| Bahasa: | eng |
| Terbitan: |
, 2018
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| Subjects: | |
| Online Access: |
https://zenodo.org/record/1476607 |
Daftar Isi:
- Post-operative delirium (POD) is common following Transcatheter Aortic Valve Implantation (TAVI) and is associated with adverse health outcomes. We hypothesized that cognitive impairment and anticholinergic burden may exacerbate risk of POD in TAVI due to their effects on cholinergic pathways underlying delirium. Cognitive deficits were screened using the Mini-Cog test before TAVI and anticholinergic burden assessed using the Anticholinergic Cognitive Burden (ACB) scale. Logistic regression adjusted for age, history of stroke, atrial fibrillation, diabetes and anesthesia found that neither the Mini-Cog (OR: 6.62, p=0.09) nor the ACB scale (OR: 1.62, p=0.17) were significant independent predictors of POD when assessed individually. When assessed together, patients screening positive on the Mini-Cog and with a high ACB scale score (OR 6.94, p=0.01) predicted increased risk of POD in a significant model (χ2 (6) =29.1, p<0.01). This suggests that cognitive deficits and anticholinergic burden may exert their deleterious effects on POD through a common pathway and pre-screening of risk can potentially reduce risk for POD. Keywords: Transcatheter Aortic Valve Implantation, Post-operative delirium